Healthcare Provider Details

I. General information

NPI: 1679294219
Provider Name (Legal Business Name): DANIEL KNIGHT RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2022
Last Update Date: 09/12/2022
Certification Date: 09/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 SUNNYBROOK RD
RALEIGH NC
27610-1827
US

IV. Provider business mailing address

511 LAURENS WAY
KNIGHTDALE NC
27545-7635
US

V. Phone/Fax

Practice location:
  • Phone: 984-215-3084
  • Fax:
Mailing address:
  • Phone: 919-395-0964
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number246257
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: